Individual provider Active NPI

Elizabeth Mary Burmeister, LISW, ACHP-S

  • Clinical Social Worker
  • Flagstaff, AZ
National Provider Identifier
1255689535
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 1501138 Issued in OH
Practice address
11463 N Lilac LN
Flagstaff, AZ 86004-5609
Phone
(440) 773-5102
NPI assigned
Aug 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-12542 AZ
Clinical Social Worker 1041C0700X I 1501138 OH Primary

Addresses

Primary practice location

11463 N Lilac LN
Flagstaff, AZ 86004-5609

Mailing address

11463 N Lilac LN
Flagstaff, AZ 86004-5609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-12542AZMDSocial Worker
I 1501138OHMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1255689535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11463 N LILAC LN",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860045609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11463 N LILAC LN",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860045609",
            "telephone_number": "440-773-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURMEISTER",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "credential": "LISW, ACHP-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-17",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-12542",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1501138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.